Tracking S.M.A.R.T. Transitions: A Program Evaluation Public Deposited

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  • March 20, 2019
Creator
  • Cadogan, Kelly
    • Affiliation: School of Nursing
Abstract
  • Background and Rationale: Compared to their peers, children with special healthcare needs (CSHCN) are at increased risk of poor health outcomes secondary to their transition to the adult healthcare system. Various programs have been proposed to facilitate more successful transitions for CSHCN. Due to the novelty of such programs, few have been evaluated for their effectiveness in improving the transition experiences of CSHCN. Purpose: The purpose of this project was to evaluate compliance with the seven core domains of the social-ecological model of adolescent and young adult readiness for transition (SMART) model and improve upon the Duke Complex Care Clinic by performing a program evaluation, implementation of a pilot patient transition readiness tracking tool and a patient/parent survey. Methodology: Cross-sectional data was acquired from patient and parent surveys and data from retrospective chart reviews to determine clinic compliance with the SMART model. Following the initial program evaluation, a pilot transition readiness tracking tool was implemented. Results: Fifty patient records were included and 72% had all seven SMART domains documented and were considered 100% complete. Overall the charts were 94.58% complete. Transition beliefs and expectations was the lowest represented domain found only in 76% of patient charts. No correlation was found between gender, age, number of clinic visits or disease type and completeness of documentation of all domains. Twenty-three patients/parents were surveyed over 18 weeks. Seventeen questions were asked using a five-point Likert scale; the average scaled response was 3.74/5. A total of 15 patients were included in the pilot testing of the transition tracking tool. Of the 15 patients, 11 patients had one goal entered; two patients had three goals while the remaining two patients had two goals; no follow-up was completed on any of the patients’ goals. Conclusions: Transition beliefs and expectations should be further assessed and addressed in patient transition visits. Overall patients and parents were satisfied with their care at the clinic and the support given by providers and caregivers yet expressed low confidence in their ability to transition successfully. Further modification of the patient tracking tool and clinic flow should improve patient transition outcomes.
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Rights statement
  • In Copyright
Advisor
  • Waldrop, Julee
  • Maslow, Gary
  • Jessup, Ann
Degree
  • Doctor of Nursing Practice
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2017
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